| NPI | 1821024688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 154978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44287) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2019-04-19 |